Organization
SOUTH PLACER SURGERY CENTER L P
Active
Other names
Sutter Sierra Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
BRADLEY HEATON (CEO)
(916) 566-4907
Entity
Organization
Contact information
Practice address
8 MEDICAL PLAZA DRIVE, SUITE 100, ROSEVILLE, CA 95661-2185
(916) 677-5070
(916) 677-5071
Mailing address
8 MEDICAL PLAZA DRIVE, SUITE 100, ROSEVILLE, CA 95661-2185
(916) 577-5070
(916) 577-5071
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
03000772
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
220182400
US DEPT OF LABOR
—
01
—
AS1608
BLUE CROSS
—
05
—
SUR01608F
—
CA
01
—
ZZZH3100Z
BLUE SHIELD
CA
Enumeration date
07/15/2005
Last updated
05/07/2024
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